• Archives of Plastic Surgery
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• 제47권5호
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• pp.483-486
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• 2020

Midline clefts of the upper lip are rare, and it is therefore important that surgeons have access to a methodical approach for when these presentations are encountered. We adapted principles of the anatomic subunit approximation for unilateral cleft lip, to the repair of midline clefts. The overt use of anatomic landmarks to define the repair results in a design that inherently adjusts to varying degrees of clefts and can accommodate asymmetries. The "measure twice, cut once" style is an advantage to new surgeons and to surgeons who seldom encounter this presentation. We describe the details of surgical repair in the context of a patient with Pai syndrome and associated nasal hamartomas that resulted in nasolabial asymmetry. This is the first report of surgical outcome following treatment of Pai syndrome and includes early and 5-year follow-up. The system of repair that we describe is applicable to both symmetric and asymmetric midline clefts.

• 대한정형외과스포츠의학회지
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• 제7권1호
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• pp.19-23
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• 2008

족관절 만성 외측 불안정증을 비해부학적인 방법으로 재건한 후에 발생하는 여러가지 문제점들을 해결하기 위하여 해부학적으로 재건하는 여러가지 방법이 보고되었다. 해부학적인 위치로 재건하는 것이 정상 관절 역학과 안정성을 회복하는데 중요하다. 해부학적인 재건 방법의 가장 큰 문제점은 인대를 정상적인 주행 방향으로 재건하는 것이 매우 어렵다는 점인데, 저자는 전거비 인대와 종비 인대가 서로 인접하여 위치하므로 두 인대의 비골측 부착부에 한 개의 터널을 만드는 것이 각각의 인대가 통과 할 별도의 터널을 만드는 것보다 좀 더 해부학적이라고 생각하였다. 이 논문에서는 외측 인대의 해부학적 재건에 필요한 기초 지식을 알아보고 반건양건을 이용한 재건 수술 방법을 소개하였다.

• 대한족부족관절학회지
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• 제9권2호
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• pp.197-200
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• 2005

We performed lateral ankle ligament reconstructions using Achilles allograft on patients who had failed previous Brostrom repair. The bone plug is fixed with an interference screw into the calcaneus, the tendon graft is passed through a fibular tunnel, and then anchored into the talus with the biotenodesis screw. The graft is strong enough to maintain joint stability until graft incorporation and remodeling occurs. In patients with chronic failed lateral ankle instability requiring graft for ligament reconstruction, this technique allows anatomic reconstruction without the need to sacrifice autogenous peroneal tendons.

• 대한정형외과스포츠의학회지
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• 제6권2호
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• pp.88-91
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• 2007

급성 족관절 염좌 후 발생하는 지속적인 불안정성은 일부의 환자들에서 결국 인대 재건술을 필요로 하게 된다. 족관절의 외측 안정성을 다시 얻기 위해 전거비 인대와 종비 인대의 직접적인 봉합에서부터 자가 조직이나 동종 조직을 이용한 재건까지 50가지가 넘는 수술적 방법들이 기술되어 왔다. 저자는 그 중의 한 가지인 제4 장 족지 신전건을 이용한 족관절의 해부학적 인대 재건술에 대해 그 이론적 근거와 술기를 기술하고자 한다.

• 대한관절경학회지
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• 제12권2호
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• pp.118-124
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• 2008

Purpose: Recent development and advances in the arthroscopic surgical techniques for anterior cruciate ligament(ACL) reconstruction have led to the ideal location for more oblique anatomic point of the femur from 10 to 10:30 o'clock(in the right knee) and from 2 to 1:30 o'clock(in the left knee) in the frontal plane. This study was performed to compare the operative methods and the radiologic results of the femoral tunnels made through the tibial tunnel(trans-tibial approach) and the anteromedial portal. Materials and Methods: From January 2003 to May 2004, on hundred reconstructions of ACL were performed. Group I(the femoral tunnel made through the tibial tunnel) consisted of 50 cases and group I(the femoral tunnel made through the anteromedial portal) consisted of 50 cases. The operative methods and the radiographic results of the femoral tunnels were compared. Results: Femoral tunnel was made more easily at more oblique anatomic point in group II than in group I. In group II, better visual field was achieved at the angle of 100? flexion of the knee joint, the risks of the posterior cortical breakage and the tunnel-graft mismatching were reduced more, and the divergence of femoral interference screw from the radiograph decreased more than in group I(p<0.05). The angle between the femoral tunnel and the longitudinal axis of ACL increased in group II. Conclusion: Anteromedial portal technique was useful for femoral tunneling toward 10 to 10:30 o'clock(in the right knee) and 2 to 1:30 o'clock(in the left knee) in ACL reconstruction. Level of Evidence:Level III, case-control study.

• 대한관절경학회:학술대회논문집
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• 대한관절경학회 제21차 추계 학술대회
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• pp.41-41
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• 2009

• 대한관절경학회:학술대회논문집
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• 대한관절경학회 제21차 추계 학술대회
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• pp.42-43
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• 2009

• 대한치과의사협회지
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• 제49권9호
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• pp.535-548
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• 2011

The anterolateral thigh flap(ALT flap) was originally described in 1984 as a septocutaneous nap based on the descending branch of the lateral circumflex artery. This nap has some significant advantages for reconstruction of the head and neck. It can be raised as a subcutaneous flap, a fasciocutaneous nap, or a myocutaneous nap and can resurface large defects in the head and neck. In addition, it has a large and long vascular pedicle, and because of the distance of the donor site from the head and neck, it can easily be harvested with a two-team approach. However, the number and locations of cutaneous perforators vary individually, and thus, it is not widely used because nap elevation is often complicated and time-consuming owing to unexpected anatomical variations. The purposes of this study are to clarify the vascular anatomy and to assess the suitability of anterolateral thigh nap for oral cavity reconstruction in Koreans. In addition, we used anterolateral thigh free nap for oral cavity reconstruction in 20 oral cancer patients from 2006 to 2011. Through our clinical experience, we discuss a series of practical "pearls and pitfalls". Our experience has not only given us new flap choice using anterolateral thigh nap in oral cavity reconstruction, but also given us a new possibility on the applicability of chimeric naps.

• Clinics in Shoulder and Elbow
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• 제26권2호
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• pp.140-147
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• 2023

Background: The management of acromioclavicular (AC) joint dislocation remains controversial. Recently, anatomic coracoclavicular (CC) fixation with a double clavicular tunnel and three flip-buttons has shown promising results. This study aimed to evaluate functional and radiological outcomes in patients with high-grade AC joint dislocation treated with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Methods: A retrospective, unicentric study was performed. The study included patients with high-grade AC joint dislocation who underwent surgery with anatomic CC fixation using double clavicular tunnels and three flip-buttons. Demographic data were obtained from medical records. A functional evaluation using subjective shoulder value (SSV), visual analog scale (VAS), and disabilities of the arm, shoulder, and hand (DASH) questionnaires was performed, and an evaluation of preoperative and postoperative comparative Zanca view images was performed. Factors associated with functional outcomes and radiological AC reduction were analyzed. Results: A total of 83 patients completed follow-up and were included in the analysis. The mean SSV, VAS, and DASH scores were 92.8, 0.8, and 6.4, respectively. Patients who had complications experienced significantly worse functional outcomes (DASH: P=0.037). Suboptimal final AC reduction was observed in nine patients (11.1%), and significantly more frequently in patients older than 40 years (P=0.031) and in surgeries performed more than 7 days after injury (P=0.034). There were two reoperations (2.4%). Conclusions: Anatomic CC fixation with a double clavicular tunnel and three flip-buttons leads to good functional outcomes, low complication rates, and high rates of optimal AC reduction.

• Journal of International Society for Simulation Surgery
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• 제2권2호
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• pp.83-86
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• 2015

Recently, computer-assisted surgery is popular for performing well-planned operations. Computer-aided navigation system is helpful in maxillofacial surgery with real time instrument positioning and clear anatomic identification. Generally, segmental mandibulectomy and reconstruction flap surgery have done by extra-oral approach such as, submandibular approach. This case report describes performing intra-oral segmental mandibulectomy and reconstruction with monocortical deep circumflex iliac artery (DCIA) flap and CT guided implant surgery by using computer-aided surgical guide and navigation for managing ameloblastoma in a 31 years old female patient.